Type 2 diabetes in newly diagnosed 'can be reversed

An extreme eight-week diet of 600 calories a day can reverse Type 2 diabetes in people newly diagnosed with the disease, says a Diabetologia study.

Newcastle University researchers found the low-calorie diet reduced fat levels in the pancreas and liver, which helped insulin production return to normal.

Seven out of 11 people studied were free of diabetes three months later, say findings published in the journal.

More research is needed to see whether the reversal is permanent, say experts.

Type 2 diabetes affects 2.5m people in the UK. It develops when not enough insulin is produced in the body or the insulin that is made by the body doesn't work properly.

When this happens, glucose - a type of sugar - builds up in the blood instead of being broken down into energy or fuel which the body needs.

The 11 participants in the study were all diagnosed with Type 2 diabetes within the previous four years.

They cut their food intake drastically for two months, eating only liquid diet drinks and non-starchy vegetables.

Fat loss
After one week of the diet, researchers found that the pre-breakfast blood sugar levels of all participants had returned to normal.

MRI scans of their pancreases also revealed that the fat levels in the organ had decreased from around 8% - an elevated level - to a more normal 6%.

Three months after the end of the diet, when participants had returned to eating normally and received advice on healthy eating and portion size, most no longer suffered from the condition.

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It offers great hope for many people with diabetes.

Prof Keith Frayn
University of Oxford
Professor Roy Taylor, director of Newcastle Magnetic Resonance Centre at Newcastle University and lead study author, said he was not suggesting that people should follow the diet.

"This diet was only used to test the hypothesis that if people lose substantial weight they will lose their diabetes.

"Although this study involved people diagnosed with diabetes within the last four years, there is potential for people with longer-standing diabetes to turn things around too."

Susceptibility question
Dr Ee Lin Lim, also from Newcastle University's research team, said that although dietary factors were already known to have an impact on Type 2 diabetes, the research showed that the disease did not have to be a life sentence.

"It's easy to take a pill, but harder to change lifestyle for good. Asking people to shift weight does actually work," she said.

However, not everyone in the study managed to stay free of diabetes.

"It all depends on how much individuals are susceptible to diabetes. We need to find out why some people are more susceptible than others, then target these obese people. We can't know the reasons for that in this study," Dr Lim said.

Professor Edwin Gale, a diabetes expert from the University of Bristol, said the study did not reveal anything new.

"We have known that starvation is a good cure for diabetes. If we introduced rationing tomorrow, then we could get rid of diabetes in this country.

"If you can catch people with diabetes in the early stages while beta cells are still functioning, then you can delay its onset for years, but you will get it sooner or later because it's in the system."

But Keith Frayn, professor of human metabolism at the University of Oxford, said the Newcastle study was important.

"People who lose large amounts of weight following surgery to alter their stomach size or the plumbing of their intestines often lose their diabetes and no longer need treatment.

"This study shows that a period of marked weight loss can produce the same reversal of Type 2 diabetes.

"It offers great hope for many people with diabetes, although it must be said that not everyone will find it possible to stick to the extremely low-calorie diet used in this study."

Dr Iain Frame, director of research at Diabetes UK, which funded the study, said the diet was not an easy fix.

"Such a drastic diet should only be undertaken under medical supervision. Despite being a very small trial, we look forward to future results particularly to see whether the reversal would remain in the long term."

Thanks for posting this. I think another approach that should be considered, and might be complementary to the diet change approach, is to take supplements to improve the action of the insulin, and also to improve the function of the pyruvate dehydrogenase complex, which couples the glycolysis pathway to the Krebs cycle in the mitochondria.

Chromium, vanadium and cinnamon have been found to help insulin function. The pyruvate dehydrogenase complex needs B-complex vitamins, lipoic acid and magnesium. I am prediabetic myself, and I think this regimen is helping, based on symptoms associated with my feet, which is where problems often show up first with diabetes.

Hey Rich - If you don't mind me asking could you elaborate on what symptoms that you experienced in your feet with a prediabetic diagnosis? I have had what appears to be some edema in my calves, including loss of hair and a shiny, scaly (or wrinkled look) to the skin if you pinch it up. I also get some mild swelling in my feet if sitting for awhile (use compression stockings sometimes) along with the swelling commons some neuropathy.

When I first became sick I noticed that the bottoms of my feet will turn black if I sit for awhile, but I have had ever test my cardiologist, vascular doc and Mayo Clinic and they can not tell me wy my feet turn black. They just say I have cyanosis, but it did not start until I got CFS.

I have been diagnosed as prediabetic to. There was a good article about 2 years ago in the "Townsend Letter" by a Dr that I can't remember right of hand (Dr. Hahn maybe)??

Thanks

Edit - I also have abnormally high triglycerides in corelattion to my other lipid levels. My HDL tends to run right at the low end of normal levels.

My symptoms were considerably milder than what you have described. They are a little hard to describe. In the area of the toes on both feet, there was sort of a "pre-numbness" feeling. Not pins and needles, and not total loss of feeling, but an unusually sensory sensation. That's about the best I can do to describe it. It was very evident to me, though, that something was not normal in the feeling of my toes, and this occurred each night as I was sleeping. The supplements I mentioned have stopped this sensation, whatever it is.

You are the professional here and I'm pretty sure that supplements directed towards insulin function help with diabetes. But in addition to that what also came to my mind was that caloric restriction has multiple pathways where it seems to influence the health of humans in a beneficial way:

In the meantime, researchers are plenty busy trying to figure exactly how CR boosts life span. Numerous theories have been proffered over the years. Among them:

CR slows the rate of cell division. In the 1960s, UC San Francisco gerontologist Leonard Hayflick discovered that cells, at least in the laboratory, appear to contain a finite number of divisions. After a cell divides 50 or so times, it dies. Researchers have speculated that CR slows cellular metabolism enough that those divisions occur less frequently, effectively slowing the cell's rate of aging. A reduced rate of cell division might also help explain why lab animals on low-calorie diets seem to suffer less from late-life cancers.

Contrarily, several studies have shown that, at least at the level of individual cells, CR may slightly boost metabolic rate.

"There is strong evidence that decreasing cellular metabolism is not involved in CR-induced life extension," said Edward Masoro, a professor of physiology at the University of Texas Health Science Center at San Antonio.

CR lowers glucose or sugar levels in the blood, reducing the accumulation of sugar on long-lived proteins, an effect that tends to disrupt cellular functions.

CR boosts immunological response and increases levels of protective hormones. Some scientists have noted that CR seems to work, in part, by alerting the body that food is scarce. The body responds by slowing its metabolism, boosting internal efficiencies, releasing energy stores in fat and upping the production of protective hormones that allow cells to withstand greater stress.

In roundworms, for example, starvation (or overcrowding) prompts the microscopic animals to slip into a kind of suspended animation, in effect shutting down until better times.

CR reduces mitochondrial damage. This view currently enjoys the greatest support, a fact not without some irony since the damage appears to be an unavoidable consequence of simply being alive. In every cell, there are tiny factories called mitochondria that convert raw fuel into usable energy. In the course of doing so, they produce molecules called free radicals as a by-product.​

Strawberries: Flavonoids Could Represent Two-Fisted Assault On Diabetes and Nervous System Disorders

ScienceDaily (June 27, 2011) A recent study from scientists at the Salk Institute for Biological Studies suggests that a strawberry a day (or more accurately, 37 of them) could keep not just one doctor away, but an entire fleet of them, including the neurologist, the endocrinologist, and maybe even the oncologist.

Investigations conducted in the Salk Institute's Cellular Neurobiology Laboratory (CNL) will appear in the June 27, 2011, issue of PLoS ONE. The report explains that fisetin, a naturally-occurring flavonoid found most abundantly in strawberries and to a lesser extent in other fruits and vegetables, lessens complications of diabetes. Previously, the lab showed that fisetin promoted survival of neurons grown in culture and enhanced memory in healthy mice. That fisetin can target multiple organs strongly suggests that a single drug could be used to mitigate numerous medical complications.
"This manuscript describes for the first time a drug that prevents both kidney and brain complications in a type 1 diabetes mouse model," says David Schubert, Ph.D., professor and head of the Cellular Neurobiology Laboratory and one of the manuscript's co-authors. "Moreover, it demonstrates the probable molecular basis of how the therapeutic is working."
Pam Maher, Ph.D., a senior staff scientist in the CNL, is the study's corresponding author. Maher initially identified fisetin as a neuroprotective flavonoid ten years ago. "In plants, flavonoids act as sunscreens and protect leaves and fruit from insects," she explains. "As foods they are implicated in the protective effect of the 'Mediterranean Diet.'"
Other celebrity flavonoids include polyphenolic compounds in blueberries and red wine.
Although her group's focus is neurobiology, Maher and colleagues reasoned that, like other flavonoids, fisetin might ameliorate a spectrum of disorders seen in diabetic patients. To test this, they evaluated effects of fisetin supplementation in Akita mice, a very robust model of type 1 diabetes, also called childhood onset diabetes.
Akita mice exhibit increased blood sugar typical of type 1 diabetes and display pathologies seen in serious human complications of both type 1 and 2 diabetes. Those include diabetic nephropathy or kidney disease, retinopathy, and neuropathies in which patients lose touch or heat sensations.
Mice fed a fisetin-enriched diet remained diabetic, but acute kidney enlargement-or hypertrophy-seen in untreated mice was reversed, and high urine protein levels, a sure sign of kidney disease, fell. Moreover, fisetin ingestion ameliorated anxiety-related behaviors seen in diabetic mice. "Most mice put in a large area become exploratory," says Maher. "But anxious mice tend not to move around. Akita mice showed enhanced anxiety behavior, but fisetin feeding restored their locomotion to more normal levels."
The study also defines a likely molecular mechanism underlying these effects. Researchers observed that blood and brain levels of sugars affixed to proteins known as advanced glycation end-products-or AGEs-were reduced in fisetin-treated compared to untreated Akita mice. These decreases were accompanied by increased activity of the enzyme glyoxalase 1, which promotes removal of toxic AGE precursors.
The discovery of an AGE-antagonizing enzyme upregulated by fisetin is very intriguing, because substantial evidence implicates high blood AGE levels with many if not most diabetic complications. "We know that fisetin increases activity of the glyoxalase enzyme and may increase its expression," says Maher. "But what is important is that ours is the first report that any compound can enhance glyoxalase 1 activity."
Interestingly, excessively high AGE levels also correlate with inflammatory activity thought to promote some cancers. In fact, studies published by others confirm that fisetin decreases tumorigenicity of prostate cancer cells both in culture and in animal models, which if supported would represent a major added incentive to eat your strawberries.
To ingest fisetin levels equivalent to those fed Akita mice, Maher estimates that humans would have to eat 37 strawberries a day, assuming that strawberry fisetin is as readily metabolizable by humans as fisetin-spiked lab chow is by mice. Rather than through diet, Maher envisions that fisetin-like drugs could be taken as a supplement.
Schubert notes that fisetin is also effective in mouse models of Alzheimer's disease. "We and others have shown that diabetes may be a risk factor for Alzheimer's disease, making identification of a safe prophylactic like fisetin highly significant," he says.
Maher acknowledges that the public may be suffering from flavonoid-fatigue, given media coverage of the promises of these compounds. "Polyphenolics like fisetin and those in blueberry extracts are found in fruits and vegetables and are related to each other chemically," she says. "There is increasing evidence that they all work in multiple diseases. Hopefully some combination of these compounds will eventually get to the clinic."
Schubert concurs that their findings only reinforce what common sense and our mothers told us was a healthy lifestyle. "Eat a balanced diet and as much freshly prepared organic food as possible, get some exercise, keep socially and mentally active and avoid sodas with sugar and highly processed foods since they can contain high levels of AGEs," he advises.
But he also worries that hoops that must be jumped through to bring a natural product like fisetin, as opposed to a totally synthetic drug, to clinical trials are daunting because it is difficult to protect patents on natural products. "We will never know if a compound like fisetin works in humans until someone is willing to support a clinical trial."
Also contributing to this study were Richard Dargusch and Jennifer L. Ehren, Ph.D.,of the Cellular Neurobiology Laboratory, and Kumar Sharma, M.D., and Shinichi Okada, M.D., Ph.D., of the Department of Medicine at University of California, San Diego.
Funding for the study came from the Fritz B. Burns Foundation, the Juvenile Diabetes Research Foundation, the Hewitt Foundation, and the National Institutes of Health

Hi, waverunner.
Chromium, vanadium and cinnamon have been found to help insulin function.

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Hi Rich,
I was looking into supplementing cinnamon to improve insulin function, and am wondering how much you take daily? and do you buy capsules or make your own?

I've always been more on the hypoglycemic than diabetic side, but I've read that hyperinsulemia can can look like either one, and many of it's symptoms sound a like many of my CFS/ME symptoms. I'm not thinking it's a cause, but it might be an exacerbation.
Thanks!
Penny

Hi Rich,
I was looking into supplementing cinnamon to improve insulin function, and am wondering how much you take daily? and do you buy capsules or make your own?

I've always been more on the hypoglycemic than diabetic side, but I've read that hyperinsulemia can can look like either one, and many of it's symptoms sound a like many of my CFS/ME symptoms. I'm not thinking it's a cause, but it might be an exacerbation.
Thanks!
Penny

Click to expand...

Hi, Penny.

I think it takes something like 3 grams per day of cinnamon to be effective. That's a lot, and I haven't always been very regular about it.

Yesterday I received in the mail a promotional pamphlet for a new combined supplement for treating (or preventing) type 2 diabetes. I usually route these things to the circular file, but this one caught my eye, because it seems to have some biochemistry behind it. After wading through the rhetoric, I learned that this supplement (modestly called the "Blood Sugar Bombshell") has 3 ingredients: 200 micrograms of chromium, 500 milligrams of some sort of concentrated cinnamon extract, and 400 milligrams of benfotiamine. Benfotiamine is a fat-soluble sythetic form of thiamine, vitamin B1. I was aware of the benefit of chromium and cinnamon, as I wrote in an earlier email, but I hadn't heard of using benfotiamine for diabetes control.

Benfotiamine is thought to be a better-absorbed form of thiamine because of its fat solubility. It raises the concentration of thiamine diphosphate in cells, and that is used to support the activity of the transketolase enzyme, which diverts carbohydrates into the pentose phosphate shunt on the glycolysis pathway. This shunt makes NADPH, which is necessary for several important reactions in the cells (including, by the way, the recycling of glutathione after it becomes oxidized). I think it makes sense that benfotiamine could increase the utilization of glucose by the cells, and that could help to lower the blood glucose level. I haven't tried this supplement, but it does seem to have a good biochemical basis. It has apparently been shown to decrease the so-called advanced glycation endproducts (AGE's) which result from glucose reacting with substances it shouldn't, and which are a component of ageing in humans. So that seems to be another piece of evidence that it can lower blood glucose levels.

Waverunner: I certainly agree that dietary modifications are effective in controlling type 2 diabetes, and calorie restriction does offer other advantages. Unfortunately, a lot of people, me included, would prefer to have our cake and eat it too, so to speak, and if we can improve glucose utilization, we may not have to maintain such disciplined diets. Immature and short-sighted, I know, but I think it's reality for many people.

Thanks Rich, I'm going to try the straight cinnamon to start with. It should be interesting since my problem is typically low blood sugar rather than high, but my understanding is that the cinnamon helps regulates rather than just raising or lowering. I ordered the NOW 600mg capsules, so I'll try 5 at night and see if it helps me get through the night without a blood sugar crash.

As far as diet, I think it can only do so much. I've never eaten many sweets or carbs and had blood sugar fluctuations my whole life. Just seems to be something wrong with how my body regulates. Maybe if I went very low carb (less than 20g a day) permanently I wouldn't have any problems, but that seems to leave me with less energy and muscle strength than "normal".

Waverunner: I certainly agree that dietary modifications are effective in controlling type 2 diabetes, and calorie restriction does offer other advantages. Unfortunately, a lot of people, me included, would prefer to have our cake and eat it too, so to speak, and if we can improve glucose utilization, we may not have to maintain such disciplined diets. Immature and short-sighted, I know, but I think it's reality for many people.

Rich

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Hi Rich,

don't worry, it's not immature and short-sighted. A 600 calorie diet for 2-3 months is extreme to say the least. I don't know how these people could have worked during that time. Anything to reduce AGE's is a good thing to do but I still hope that diabetes finally can be healed through stem cell treatment.